John F Kennedy very likely had celiac disease

Dr. Peter Green, a Professor of Clinical Medicine, Director of the Celiac Disease Center at Columbia University College of Physicians and Surgeons, suspects that JFK was the victim of celiac disease an undiagnosed disease common to the Irish.

Green recently wrote in History News Network that Kennedy’s Irish heritage may have played a part in the disease, noting that it is more highly associated with Irish than many other races. The article was later picked up by our sister publication Irish America Magazine.

Green wrote, “John F. Kennedy’s long-standing medical problems started in childhood. In Kennedy’s adolescence, gastrointestinal symptoms, weight and growth problems as well as fatigue were described. Later in life, he suffered from abdominal pain, diarrhea, weight loss, osteoporosis, migraine and Addison’s disease. Chronic back problems, due to osteoporosis, resulted in several operations and required medications for chronic pain.

Green says that by the standards of the time Kennedy was extensively assessed. ”He was extensively evaluated in major medical centers including the Mayo Clinic and hospitals in Boston, New Haven and New York. Among the multiple diagnoses were ulcers, colitis, spastic colitis, irritable bowel syndrome, and food allergies. His medications included corticosteroids, antispasmotics, Metamucil and Lomotil.

However, while it is not clear that his physicians obtained a definitive diagnosis, a review of his medical history raises the possibility that JFK had celiac disease.

Green explains how celiac disease happens. “Celiac disease is caused by ingestion of gluten, which is the main protein component of wheat and related cereals, rye and barley. The small intestine develops villous atrophy that results in difficulties in the absorption of nutrients. Diarrhea and abdominal pain are common symptoms. Elimination of gluten from the diet results in resolution of the inflammatory condition in the intestine and the associated symptoms and prevention of the complications of the disease. A life-long gluten free diet is then required. People with celiac disease, providing they adhere to the diet have normal longevity.

Green notes it often occurs early in life. ”Celiac disease can present at any age. In infancy and childhood it may cause chronic diarrhea and abdominal pain, in addition to growth, behavioral and developmental problems. In older individuals the presentation of celiac disease is frequently due to the development of complications of the disease. These include anemia, osteoporosis, skin rashes or neurologic problems. The neurologic problems include neuropathy, epilepsy, ataxia (balance disorders) and migraine.

While the disease is more common in females, men are affected as well. Osteoporosis is common in patients with celiac disease; men often are more severely affected than women. Gastrointestinal symptoms in celiac disease persist for many years prior to diagnosis and are often attributed to an irritable bowel syndrome or spastic colitis.

Autoimmune disorders occur more frequently in patients with celiac disease than the general population by a factor of ten. Frequently, the autoimmune disorder assumes greater clinical significance than the celiac disease and, as a result, is diagnosed first. The associated autoimmune disorders include thyroid dysfunction, psoriasis, dermatitis herpetiformis (an intensely itchy skin rash), Sjogren’s syndrome, and Addison’s disease. Relatives of patients with celiac disease have a greater risk, not only of celiac disease, but also of other autoimmune diseases.

As to the Irish connection, Green says Kennedy may well have been more susceptible because of his heritage.

“Celiac disease was formerly considered a rare disease of childhood. It is now recognized as being very common in those of European descent, one of the most common genetically determined conditions physicians will encounter. Recent studies have demonstrated the country with the greatest prevalence to be Ireland.

In Belfast, one in every 122 have the illness. The prominent familial association of the disease indicated by the occurrence in one of ten first degree relatives and in 80 percent of identical twins points to a genetic component of the disease. However, the actual genes responsible for the disease have not been discovered, though many groups are working on the problem. It is known that there is a strong association with specific HLA genes that are required for the disease to occur, but are themselves not sufficient for the disease to be manifested.

Kennedy’s Irish heritage, long duration of gastrointestinal complaints (since childhood), diagnosis of irritable bowel syndrome and migraine, presence of severe osteoporosis, and the development of Addison’s disease all lead to a presumptive diagnosis of celiac disease. Kennedy was given steroids for his problems. Steroid use is associated with the development of osteoporosis and Addison’s disease.